(Generally, a subsection (d) hospital is an acute care hospital, particularly one that receives payments under Medicare's inpatient prospective payment system [IPPS] when providing covered inpatient services to eligible beneficiaries.)

Requires the counting of hours spent by an intern or resident in a nonhospital setting (that is primarily engaged in furnishing patient care) in non-patient care activities, such as didactic conferences and seminars (but excluding research not associated with the treatment or diagnosis of a particular patient).

Requires the counting as well of all the time spent on vacation, sick leave, or other approved leave that does not prolong the total time the resident is participating in the approved program beyond its normal duration.

Revises rules for counting resident time in outpatient settings with respect to GME and IME costs to include the costs of the residents' stipends and fringe benefits during the time residents spend in such a setting.